Clinical Engineering - History

History

While some trace its roots back to the 1940s, the actual term "clinical engineering" was first used in 1969. The first explicit published reference to the term "clinical engineering" appears in a paper published in 1969 by Landoll and Caceres. Cesar A. Caceres, a cardiologist, is generally credited with coining the term "clinical engineering." Of course, the broader field of "biomedical engineering" has a relatively recent history as well. The first modern professional intersociety engineering meeting to be focused on the application of engineering in medicine was probably held in 1948, according to the Alliance for Engineering in Medicine and Biology

The general notion of the application of engineering to medicine can be traced back centuries; for example, Stephen Hales's work in the early 18th century which led to the invention of a ventilator and the discovery of blood pressure certainly involved the application of engineering techniques to medicine.

The recent history of this sub-discipline is somewhat erratic. In the early 1970s, clinical engineering was thought to be a field that would require many new professionals. Estimates for the US ranged as high as 5,000 to 8,000 clinical engineers, or five to ten clinical engineers for every 250,000 of population, or one clinical engineer per 250 hospital beds.

The history of its formal credentialization and accreditation procedures has also been somewhat unstable. The International Certification Commission for Clinical Engineers (ICC) was formed under the sponsorship of the Association for the Advancement of Medical Instrumentation (AAMI) in the early 1970s, to provide a formal certification process for clinical engineers. A similar certification program was formed by academic institutions offering graduate degrees in clinical engineering as the American Board of Clinical Engineering (ABCE). In 1979, the ABCE agreed to dissolve, and those certified under its program were accepted into the ICC certification program. By 1985, only 350 clinical engineers had become certified. Finally, in 1999, AAMI after lengthy deliberation, and analysis of a 1998 survey demonstrating that there was not a viable market for its certification program decided to suspend that program, no longer accepting any new applicants as of July 1999.

The new, current Clinical Engineering Certification (CCE) program was started in 2002 under the sponsorship of the American College of Clinical Engineering (ACCE), and is administered by the ACCE Healthcare Technology Foundation. In 2004, the first year that the certification process was actually underway, 112 individuals were granted certification based upon their previous ICC certification, and three individuals were awarded the new certification. By the time of the publication of the 2006-2007 AHTF Annual Report (approx. June 30, 2007), a total of 147 individuals were included in the ranks of HTF certified clinical engineers.

New name for the Profession

A group of 30 influential persons in Biomed met on April 28 and 29, 2011 in Arlington, Virginia to examine the future of the Biomedical / Clinical Engineering / Medical Equipment Maintenance field, and to select the most appropriate name for the profession. Most of the cost was born by AAMI, who contracted professional facilitators to guide the process. AAMI was a participant, like everyone else, but didn’t exert a domineering role in the process. After two grueling days, we did arrive at a best name, based upon all of the factors. The name chosen was “Healthcare Technology Management”. The finalists were Clinical Engineering, Clinical Technology, and a few others. There was debate as to whether the final word in the name should be Support, Service or Management. After careful debate, the vast majority decided on “Healthcare Technology Management”. Everyone in the room stated that they could support the new name.

We felt that this name was accurate, easily understood by the public and other healthcare workers, and allowed for expansion of the field in the future. The word “Engineering” was limiting (from the administrator’s perspective) and unworkable from the educator’s perspective. (A college would never name an associate’s degree program “Engineering”.) Likewise, the name “Clinical” was now clear, and limited the scope of the profession to hospitals, when healthcare is clearly moving outside of the hospital. Lastly, the names “Support” and “Service” seemed to be passive and imply a sideline role instead of a leadership role.

There will be much more released about this, with many more details. But for now, this is the main thrust of the meeting.

(Represented were biomedical educators, clinical engineers, BMETs, manufacturers, ISOs, directors, nurses, administrators, and the Office of Veterans Health Administration. )